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Online Forms for Waiting Room Ease!

Moms, dads or caregivers bringing your children to our office for dental appointments:  Due to HIPAA regulations, and for the most up-to-date information about your children, it’s required that the patient forms be filled out prior to the appointment time.  To fill out the form when it is most convenient time for you, please download the form from Pediatric Dental Center’s website at http://www.pediatricdentalcenter.com/pdfFiles/NewPatientPaperwork.pdf.  This way you can fill out the form when it is the most convenient time for you and in the comfort of your own home.  You can bring the form(s) when you show up 5-minutes before your appointment time. 

If you prefer to fill out the form(s) in our waiting room, please show up at least 15 minutes prior to your child’s appointment time to fill out the information.  Thank you.

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Burlington Location

 

5495 North Bend Road, Suite 102

Burlington, KY 41005

(859) 534-5640

 

 

Crestview Hills Location

 

220 Thomas More Pkwy.
Crestview Hills, KY 41017

(859) 341-3012

 

 

Office Hours

 

Monday - Thursday

8:00 am - 5:00pm

 

 Please call to schedule

your child's appointment

 

Contact Us

 

Burlington

Phone: (859) 534-5640

Fax: (859) 534-5922

 

Crestview Hills

Phone: (859) 341-3012

Fax: (859) 818-0505

 

Email

ericsoper@gmail.com

 

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